Table 7 Site B summary
From: The interplay of contextual elements in implementation: an ethnographic case study
Evidence | Teamwork | Communication | Leadership* |
|---|---|---|---|
-Already had a practice algorithm but did not use it or refer to it consistently | -Teamwork generally perceived as adequate, but staff somewhat divided | -Functional but uneven communication about patients and workload | -Recent promotion of ACC pharmacist to middle manager (MM) |
-Staff was unevenly open to a new algorithm | -Less cohesiveness as a team | -Used all means available to communicated (email, phone, IM, face to face) | -MM very supportive of ACCII |
-Concern about losing clinical judgment if just following an algorithm | -Less willingness to pitch in to even out the work load | -Deeper level of communication about quality improvement often lacking at outset | -MM interested in QI approaches & solicited staff ideas |
-Uneven interest in change and improvement | -Site designed tracking system to manage patients before ACCII started | -MM supported local coordinator (liaison to ACCII) | |
-MM supported by pharmacy leadership |